As with a lot of things to do with health, when it comes to eating our 5 portions of fruit and veg, there is a distinct difference between what people know and what they do.

Undoubtedly, the knowledge is already there as over 96% of people admit to knowing that we should be eating 5 portions of fruit and veg every day.1

This understanding is largely due to the Department of Health's hugely successful awareness campaigns. Between 2001-2002 and 2007-2008, over £12 million was spent on promoting their ‘5-A-DAY' campaign and in terms of raising awareness, this money appears to have been well spent.2

However, these awareness campaigns don't seem to be translating into action as 89% of people claim that despite knowing about the 5-a-day message, they're not actually achieving five portions of fruit and veg a day.

So what's going on? Why is there such a disconnect between what people know and what they do?

According to the research, the main barriers to achieving the 5-a-day target are a lack of convenience, confusion, cost and psychological barriers.

Innocent, who commissioned the research and wrote the report, has created a new way of looking at this 5-a-day problem known as ‘reality eating'. This new model allows healthcare professionals such as GPs, nurses, dietitians and nutritionists to base their advice on easy, practical steps that can make a real difference rather than relying on overly strict doctrines. By encouraging people to eat healthy foods in a way that fits into their hectic day-to-day lives, reality eating makes it that little bit easier to be healthier.

This new approach to healthy eating brings the 5-a-day issue back to basics and provides healthcare professionals with practical solutions for patients and indeed themselves.

Why should people get their 5-a-day?Research suggests that consuming plenty of fruit and veg can reduce the risk of coronary heart disease and strokes.3 The risk of certain types of cancer is linked to diet and, research suggests, these are highly preventable through better diet, drinking and exercise habits.4

For example, the risk of colorectal (bowel) cancer may be reduced by a diet rich in fibre or fresh fruit and veg.5 Also, adults who are not classified as obese consume more fruit and veg than those who are.6

The reality of 5-a-dayKnowledge of the 5-a-day campaign is high, with 96% of the 1,048 adults surveyed by Opinion Health1 being aware that they should consume at least five portions of fruit and veg a day. However, only 11%1 of people are managing to achieve this figure every day.

And that includes the very people giving the advice:

47% of dietitians and nutritionists, and 82% of nurses who were surveyed admitted they fail to reach their 5-a-day target every day themselves

Only 18% of nutritionists think that the majority of their patients achieve their 5-a-day target most of the time

Only 3% of nurses believe patients achieve their 5-a-day target most of the time.

So what's stopping people hitting that magic number 5?The new research found that practicality, time and external influences were major issues for people. Over a quarter of those we spoke to said that work and day-to-day living often got in the way of achieving their 5-a-day target, with over 35% agreeing that fruit and veg are not always readily available.

As a result of busy lifestyles, people are eating out more and when they do eat in, they tend to opt for more convenience foods. This lack of control over what goes into our meals can lead to us consuming less nutritious meals.

The research also showed that just under a third of consumers thought that the nutritional advice supplied to the public was difficult to follow, claiming that the information:

was often too confusing;

contained too many conflicting messages; and

was full of manufacturers making false claims in a bid to drive sales.

Leading psychologist, Gladeana McMahon, argues that people have so much to remember these days as to what they should and shouldn't be doing, that it all becomes overwhelming. For example, she notes that "We are told to drink 8 glasses of water a day, avoid refined sugar, watch our alcohol units, avoid too much salt... eat 5 portions of fruit and veg a day and so on. You could argue it is a full-time occupation just remembering what you have to do and when, and then on top of it all don't forget your 10,000 paces a day."

Reality EatingSo, all that needs to happen now is to make eating that fruit and veg seem really easy! Here are some tips and advice that take real people with real lives into account. First things first, a quick recap on what a portion is.

A portion is about 80g of fruit or veg. This is roughly equal to:

an apple, orange, banana, or similarly sized fruit;

two plums, nectarines or similarly sized fruit;

a handful of grapes or berries;

a slice of melon, pineapple or large fruit;

one tablespoon of raisins or other dried fruit;

two serving spoons of cooked veg e.g., broccoli or carrots;

two serving spoons of beans and pulses (only one portion per day);

a 150ml glass of fresh fruit juice.

If healthcare professionals are to inspire their patients to reach 5-a-day then the key appears to lie in providing easy to follow advice that fits with their existing lifestyles. Earlier this year the Department of Health revised it's guidelines with an update to show that smoothies can count as two portions of fruit7. However, only 27%1 of consumers are currently aware of this. Based on the DH's revision, 82% of nurses questioned said that they would recommend smoothies to their patients to help them achieve the recommended five portions of fruit and veg a day (depending on individual patient needs).

Dr Matt Capehorn, obesity management specialist, says; "Healthcare professionals are in a unique position to empower people to make easy choices when it comes to diet and healthy eating advice, especially for those who are overweight or obese as these people rarely achieve their 5-a-day. However, these solutions need to be simple and appetising if patients are to succeed. Easy food swaps to convenient products like smoothies or adding vegetables to sauces and soups are straightforward solutions that are more likely to increase fruit and vegetable consumption than strict and prescriptive diet plans."

Tips for you and your patientsSo here are our reality eating tips to get you and your patients on the way to 5-a-day:

At work

Keep a bag of raisins or dried fruit, like cranberries and dates, in your bag, briefcase or desk drawer for a quick and easy snack

Drink a smoothie to fill the gap. A 250ml innocent smoothie will give you two portions of fruit in one go

Try to buy vegetarian sandwiches and wraps for lunch. They are usually low in calories and can give you two servings of veg in just one sandwich.

"We all agree that eating whole fruit and veg is the ideal but we also know that this can be difficult. Make it simpler by substituting with practical alternatives like smoothies or soups. Every little contribution helps", says Fiona Hunter, registered nutritionist.

At home

Make a fruit bowl part of your kitchen. Apples, pears, bananas, oranges and cherry tomatoes don't need to be kept in the fridge - keep them in your fruit bowl so they're always handy

Keep your freezer well stocked with frozen veg like peas, edamame beans and spinach. Try throwing a handful into meat-based recipes like spaghetti bolognese or to bulk up a soup

Keep your cupboards well stocked with canned fruit and veg, like tomatoes, pineapples and pulses to jazz up salads, pizzas and puds.

Dr Shilpee Aggarwal, nutritionist for innocent, says; "making small changes to your diet can have a relatively big impact. We were delighted that the Department of Health recognised that innocent smoothies can count as two portions of your 5-a-day. We hope that this revision will encourage healthcare professionals to recommend smoothies as a tasty, convenient way to help their patients achieve 5-a-day."

6. National Diet and Nutrition Survey. A survey carried out in Great Britain on behalf of the Ministry of Agriculture, Fisheries and Food and the Departments of Health, by the Social Survey Division of the Office for National Statistic and Medical Research Council Human Nutrition Research, London: The Stationery Office. 2000.

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